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Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders

Published online by Cambridge University Press:  26 November 2009

K. M. Scott*
Affiliation:
Department of Psychological Medicine, University of Otago, Wellington, New Zealand
J. E. Wells
Affiliation:
Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
M. Angermeyer
Affiliation:
Center for Public Mental Health, Gösing am Wagram, Austria
T. S. Brugha
Affiliation:
Department of Health Sciences, University of Leicester, Leicester, UK
E. Bromet
Affiliation:
Department of Psychiatry, SUNY Stony Brook, USA
K. Demyttenaere
Affiliation:
University Hospital Gasthuisberg, Leuven, Belgium
G. de Girolamo
Affiliation:
IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
O. Gureje
Affiliation:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
J. M. Haro
Affiliation:
Fundació Sant Joan de Déu, CIBER en Salud Mental, Sant Boi de Llobregat, Barcelona, Spain
R. Jin
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
A. Nasser Karam
Affiliation:
Department of Psychiatry and Clinical Psychology, Saint George Hospital University Medical Center; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School; Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
V. Kovess
Affiliation:
Fondation MGEN pour la Sante Publique, Paris, France
C. Lara
Affiliation:
Autonomous University of Puebla, Puebla, Mexico
D. Levinson
Affiliation:
Mental Health Services, Ministry of Health, Jerusalem, Israel
J. Ormel
Affiliation:
University Medical Center Groningen, University of Groningen, The Netherlands
J. Posada-Villa
Affiliation:
Colegio Mayor de Cundinamarca University, Bogata, Colombia
N. Sampson
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
T. Takeshima
Affiliation:
National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
M. Zhang
Affiliation:
Shanghai Mental Health Center and Shanghai Jiaotong University Mental Health Center, China
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: Dr K. M. Scott, PO Box 7343, Wellington 6242, New Zealand. (Email: kate.scott@otago.ac.nz)

Abstract

Background

Prior research on whether marriage is equally beneficial to the mental health of men and women is inconsistent due to methodological variation. This study addresses some prior methodological limitations and investigates gender differences in the association of first marriage and being previously married, with subsequent first onset of a range of mental disorders.

Method

Cross-sectional household surveys in 15 countries from the WHO World Mental Health survey initiative (n=34493), with structured diagnostic assessment of mental disorders using the Composite International Diagnostic Interview 3.0. Discrete-time survival analyses assessed the interaction of gender and marital status in the association with first onset of mood, anxiety and substance use disorders.

Results

Marriage (versus never married) was associated with reduced risk of first onset of most mental disorders in both genders; but for substance use disorders this reduced risk was stronger among women, and for depression and panic disorder it was confined to men. Being previously married (versus stably married) was associated with increased risk of all disorders in both genders; but for substance use disorders, this increased risk was stronger among women and for depression it was stronger among men.

Conclusions

Marriage was associated with reduced risk of the first onset of most mental disorders in both men and women but there were gender differences in the associations between marital status and onset of depressive and substance use disorders. These differences may be related to gender differences in the experience of multiple role demands within marriage, especially those concerning parenting.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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